Head and Neck Imaging

Epistaxis

nasal bleeding. The nose is supplied by branches of both the internal and external carotid artery, and numerous anastomoses exist between both systems in this region. Most patients with epistaxis have bleeding from Kiesselbachs plexus on the anterior septum. The most common cause of nasal bleeding is trauma. Drying of the nasal mucosa may be responsible for discrete bleeding. Hypertension may also be the reason, but other causes have to be excluded in these patients. A nasal foreign body (frequent in children) may cause epistaxis. A septal perforation, which is often iatrogenic, but sometimes caused by Wegeners granulomatosis head and neck manifestation or lethal midline granuloma, may also cause epistaxis. Persistent or recurrent epistaxis may be caused by a haematological disease, a sinonasal neoplasm or hereditary haemorrhagic telangiectasia; in male adolescents, an angiofibroma should be excluded.

RH